Medical instrument

ABSTRACT

There is disclosed an attachment designed to be carried by a clamping tool such as an hemostat for providing said tool with the capability of sealing the end of a fluid carrying vessel such as a blood vessel by means of staples. A staple cartridge is easily secured to an hemostat; and while the hemostat temporarily clamps and seals the end of a blood vessel, staples are smoothly ejected thereby perfecting a more permanent seal and permitting the removal of the hemostat.

United States Patent [72] Inventor David T. Green Norwalk, Conn. [21Appl. No. 766,544 [22] Filed Oct. 10, 1968 [45] Patented Apr. 27, 1971[73] Assignee United States Surgical Corporation Baltimore, Md.

[54] MEDICAL INSTRUMENT 15 Claims, 17 Drawing Figs.

[52] U.S.Cl 227/111, 227/ l 9 [51] Int. Cl 1325c 5/02 [50] FieldoiSearch 227/19; 29/212 (D); 128/325, 334, 337

[56] References Cited UNITED STATES PATENTS 1,452,373 4/1923 Gomez227/19UX 2,301,622 1 1/1942 Hambrecht 227/19UX 2,853,074 9/1958 Olson227/19UX 2,874,384 2/ I 959 Krone 227/19UX 3,082,426 3/1963 Miles 29/2123,269,631 8/1966 Takaro 227/ 19X Primary Examiner-Granville Y. Custer,Jr. An0meyFleit, Gipple & Jacobson permanent seal and permitting theremoval of the hemostat.

PATENTED m2? 197:

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PATENTED APRZ 7197! 3.576288- SHEET u 0P4 1 b INVENTOR' DAVID T. GREENUZZ/ 4W, 2% M ATTORNEYS MEDICAL INSTRUMENT BACKGROUND OF THE INVENTIONWhenever the severance of a blood vessel is made necessary in the courseof a surgical operation, it is also necessary to seal the open ends ofthe vessel in order that the patient does not lose an excessive amountof blood. It is therefore general practice to use hemostats to seal openblood vessels either for the entire duration of the surgical procedureor until the vessels can be more permanently sealed by means of surgicalthread manually positioned by the surgeon.

If it is the practice to employ the hemostat clamp for the duration ofthe operative procedure, it is readily seen that the surgical field canbecome quite cluttered if it is necessary to clamp a large number ofvessels. If on the other hand, it is the practice to have the surgeontie each vessel with a suitable thread, it becomes obvious that theduration of the surgical procedure can be greatly increased as well asthe complexity of such a procedure.

SUMMARY OF THE INVENTION The present invention relates to a staplecartridge which is designed to be carried by a clamping tool. Theultimate goal of the invention is to provide the clamping tool with theadded capability of stapling closed the object being clamped. Moreparticularly, the staple cartridge of the instant invention is designedfor rapid attachment to an hemostat so that while said hemostat isholding closed the severed end of a blood vessel, a staple can besmoothly inserted into said vessel to perfect a more permanent seal.After the staplingaction, the hemostat can be removed without breakingthe seal.

It should be obvious from the above that an attachment such as thatcontemplated in the present invention greatly adds to the efficiency ofmost surgical procedures. The time required for the placement of astaple, according to the teachings of the present invention, is far lessthan that required for a surgeon to manually tie a blood vessel. As aresult, fewer hands and fewer hemostats are required in the operativearena and the duration of a given operation is lessened to aconsiderable degree. Such factors are of great import when a human lifeis at stake.

Accordingly, it is an object of the invention to provide an attachmentfor a clamping device which gives to such device the capability ofsealing the end of the object being clamped.

'It is another object of the invention to provide a staple cartridgewhich attaches to a hemostat making possible the simultaneous clampingand stapling of a blood vessel.

It is a further object of the invention to provide a simple andinexpensive staple cartridge in order that said cartridge can beattached to a clamping tool, employed until its staples are exhaustedand then discarded.

I It is still another object of the invention to provide a stapling.attachment for a surgical tool which can be packaged in a sterilecontainer, attached to said tool and used without the necessity forpreoperative sterilization.

It is yet a further object of the invention to provide a staplecartridge for use with an hemostat which can be easily and rapidlyattached to said hemostat thereby allowing the efiicient replacement ofan exhausted cartridge during a surgical operation.

These and other objects of the invention, as well as many of theattendant advantages thereof, will become more readily apparent whenreference is made to the following description taken in conjunction withthe accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS In FIG. I there is shown a top planview of the bracket of the present invention when attached to anhemostat;

FIG. 2 is a side elevation taken along line 2-2 of FIG. 1; FIG. 3 is across-sectional view taken along line 3-3 of FIG. I;

FIG. 4 is a cross-sectional view taken along line 4-4 of FIG.

FIG. 5 is a side elevational view taken along line 5-5 of FIG.

FIG. 6 is an exploded side elevational view of the staple magazine ofthe present invention;

FIG. 7(a) is a top plan view of the staple hammer shown in FIG. 6;

FIG. 7(b) is a top plan view of the staple housing shown in FIG. 6;

FIG. 8 is an enlarged top plan view of the staple hammer shown in FIG.7(a);

FIG. 9 is an enlarged top plan view of the staple housing shown in FIG.7(b);

FIG. 10 is a side elevation of the staple cartridge attached to anhemostat before a stapling stroke;

FIG. II is a view similar to that shown in FIG. 10 but during a staplingstroke;

FIG. 12 is a plan view of the cylindrical cam showing the functions ofthe parts of the cam groove;

FIG. I3 is an enlarged vertical cross-sectional view of an assembledstaple magazine;

FIG. I4 is a cross-sectional view of the staple magazine taken alongline 14-14 of FIG. 13;

FIG. I5 is an enlarged end elevation of an assembled staple magazineincluding the staple hammer;

FIG. I6 is an enlarged end view of the staple cartridge at thecompletion of a stapling stroke; and

FIG. I7 is an enlarged side elevation, partially in section, of thecartridge shown in FIG. 16.

DETAILED DESCRIPTION OF THE DRAWINGS Referring first to FIGS. 1 through5, there follows a description of the bracket which forms a part of thepresent invention. The bracket is shown generally at 10 and is attachedto a hemostat 12 having a pair of handle portions 14 and 16,respectively and a set of jaws, or gripping members, shown generally at18. The handle portions and the jaws rotate, in a well-known manner,about a pivotal pin 20.

The bracket 10 is securely affixed to the hemostat 12 by the coaction ofthree flange portions. The first flange portion is shown at 22 andengages one of the handle portions 16 of the hemostat I2. The secondflange portion, best shown in FIG. 3, comprises a first restraining wall24 and a second restraining wall 26, these walls, respectively, engagingthe near and the upper walls of the hemostat as shown in FIG. I. As isreadily apparent from FIGS. 1 and 3, the restraining wall 26 engages thehandle portion I6 of the hemostat I2 through the means of a resilientspring member 28. The third flange portion, best shown in FIG. 4,comprises a first restraining wall 30 and a second restraining wall 32,these walls, respectively, engaging the rear and lower walls of thehemostat as shown in FIG. 1. It is thus readily seen that by means ofthe three flange portions and the spring 28, the bracket 10 can besecurely afi'txed to the hemostat I2.

Forming a part of the bracket 10, and, as will be explained .below,aiding in the attachment of the staple magazine pf the presentinvention, is a wall 34 extending away from the body of the'hemostat I2.As best seen in FIGS. 1, 3 and 5, both walls 32 and 34 extend frombeneath the hemostat 12, with the walls 34 extending over and partiallycovering the wall 32. Threaded into the wall 34 is a pin 36, thefunction of which will also be explained below. Forming an integral partof the bracket 10 is a wall 38 which, in combination with walls 30 and32, form a chamberlike cavity shown generally at 40. As is readilyapparent when reference is made to the FIGS., the bracket 10 can easilyslide along the body of the hemostat 12 until the flange 22 encounters apin 42. And as is also readily apparent, the hemostat I2 is free tooperate as if unencumbered by the bracket I0 when said bracket is in itsrearward position as shown in FIG. I. Hereinafter, the rearwardposition, or that shown in FIG. I, will be referred to as the readinessposition while the forward position, as is shown in FIG. II, will bereferred to as the stapling position. The

reasons for such terminology will become readily apparent when theinvention is more fully explained.

With reference now to FIGS. 6 and 7, the construction of the staplemagazine is fully explained. The magazine is shown member 46 is adaptedto carry a plurality of staples in its thread grooves. Also forming anintegral part of the staple magazine is a staple housing 52 into whichthe staple carrier 46 is positioned, the housing 52 being provided witha slot 54 into which can be seated a ring 56 secured to the staplecarrier 46. As seen in FIGS. 6 and 7, the rear end of the staple housing52, adjacent the slot 54, has a relatively wide opening therein topermit the insertion of the carrier 46 with its associated ring 56.Associated with the staple housing 52, in a manner to be explainedbelow, is a staple driver 58', and positioned at the end of the driver58 is a staple driving blade 59 having a groove 82 (FIG. 17) extendingthereacross. The function of the blade 59 is to eject staples from thehousing 52 when the driver is depressed. Also forming a part of thestaple magazine is a cam housing 60 in the form of a solid block ofmaterial having therein a cylindrical bore 62. Extending through thehousing, and fixedly attached thereto, is a pin 64 having an end portion66 which extends into bore 62. As is explained below, the function ofthe pin 64, and more particularly its end portion 66, is to engage thegroove 50 of the cylindrical cam 48 and to thereby cause rotation of thestaple carrier 46. Attached to the cam housing 60 by means of a pin 68is a wedge-shaped member 70 which, as will be explained below, acts inconjunction with the bracket and the staple driver 58 to eject staplesfrom the staple housing 52.

Referring to FIGS. 8 and 9, it is readily seen that the staple drivingblade 59 is secured to the staple driver 58 at an angle A. It is alsoreadily seen that the staple housing 52 is terminated in a similarmanner. It should be noted that the housing 52 is designed in such amanner that the staple driving blade 59 slides comfortably through aslot 72 formed at the termination of the housing 52. The reason forterminating the staple driver 58 and the staple housing 52 in the mannerdescribed above will become obvious when reference is made to FIGS. 13through 15.

With reference to FIG. 13, the staple carrier 46 is shown to have aplurality of grooves 74 machined therein, said grooves fonning a threadwhose pitch angle is A. Seated in the grooves 74 are a plurality ofstaples 76. As is best seen in FIG. I4, the staples are biased in such amanner that they resiliently engage the inside walls of the staplehousing 52. In this manner, it is obvious that when the shaft of thestaple carrier 46 is rotated, the staples 76 advance, in the grooves 74,along the inside wall of the housing 52.

In view of the snug fit between the staples 76 and the housing 52, andin view of the pitch angle of the thread, the

- reason for angling the staple driving blade 59 and the slot 72 shouldbe readily apparent. More particularly, when a staple 76 is freed from agroove 74 in the staple carrier 46, it snugly rests against the walls ofthe staple housing 52; but because of the pitch angle associated withthe threads in the carrier 46, the staple rests at an angle A withrespect to the axis of the carrier 46. Therefore, to most efficientlyeject the staples from the housing 52, the staple driving blade 59 andthe slot 72 are both angled as shown in FIGS. 8 and 9. The forwardmostend of the carrier 46 is also cut at an angle so that when the carrier46 is rotated to the position in which the staple has just been releasedfrom its effects, there exists alignment between the forward end of thecarrier 46, the blade 59 and the slot 72. When in this position, thefront face of the carrier is parallel to the slot 72 and is spaced fromthe front wall of the housing 52 a uniform distance slightly greaterthan the diameter of a staple.

With reference now to FIG. 16, there is shown a front view of thestapling mechanism. It is there seen that a portion of the bracket 10forms an anvil 78 into which are machined a pair of arcuate slots 80which serve to insure the proper contour of the staple 76 at thecompletion of the stapling operation. In FIG. 16, the assembly is shownat a point in time after the end of a stapling stroke, the staple 76being embedded into a blood vessel 84.

With reference now to FIGS. 10 and 11, there follows a description ofthe operation of the present invention. In FIG. 11 it is readily seenthat the pin 36, which is rigidly secured to the bracket 10, serves bothas the pivot point for the staple driver 58 and as the means for fixedlyattaching the staple housing 52 to the bracket 10. In FIG. 10, thestaple cartridge is shown to be in its readiness position, the bracket10 slid away from the jaws 18 of the hemostat 12. Further, the camhousing 60 is in its extreme rearward position, the end portion 66 ofthe pin 64 engaging the extreme rear position of the groove 50, and thestaple ejecting wedge 70, when the instrument is in the position shownin this FIG., resting on the pin 36. In this position, the hemostat canbe operated as if totally unencumbered by the bracket 10 and itsassociated staple magazine. The hemostat I2 is here shown to be securelyclamping the end of a blood vessel 84.

Once a blood vessel is sealed by means of the hemostat 12, the bracketI0 is slid forward on the hemostat until the flange 22 encounters thepin 42. At that time, the cam housing 60 is manually slid toward thejaws 18 of the hemostat to accomplish the stapling of the vessel 84.When positioned as shown in FIG. 10, the staple next ready to be ejectedfrom the staple housing 52 is remote from its ejection position anamount corresponding to one complete revolution of the staple carrier46. It therefore becomes readily apparent that for proper operation ofthe assembly, the groove 50 in the cylindrical cam 48 must be such thatone complete revolution of the staple carrier 46 results each time thecam housing 60 is stroked in a forward direction. It is also readilyapparent that for proper operation of the staple cartridge, thestaple-ejecting wedge 70 must not operate the driver 58 until a staplehas reached its proper ejection position. This is accomplished bypositioning the wedge 70 so that it engages the wall 38 only after astaple is in position for ejection.

Referring now to FIG. 12, the functions of the cam 48 and its groove 50are best explained. As pictured in FIG. 12, the pin end 66 engages thegroove 50 in a manner similar to that shown in FIG. 10. When the camhousing 60 is moved in the forward direction, the pin slides in thegroove 50 in a manner which causes rotation of the staple carrier 46.After one completed revolution of the carrier 46, that amount necessaryto advance a staple into a position ready for ejection, the cam cylinder60 continues to move forward without rotating the carrier 46. Theinterval during which the staple carrier 46 rotates is termed theindexing period; and the period during which the cam cylinder 60 slidesforward without a corresponding rotation in the carrier 46 is termed thestapledriving period. As is best seen in FIG. 10, the staple-drivingperiod is that period between the initial engagement of thestaple-ejecting wedge 70 with the wall 38 of the bracket 10 and thecompletion of the stroke of the staple driving blade 59.

In FIG. 11, the assembly is shown at the end of a staple drivinginterval. At this time, the cam housing 60 is at its forwardmostposition and the staple 76 is securely fastened to the blood vessel 84.At this time, the surgeon strokes the cam housing 60 in the rearwarddirection and then slides the bracket 10 back from the jaws 18 of thehemostat thus returning the apparatus to that position shown in FIG. 10.As is evident when viewing FIG. 12, the return stroke of the cam housing60 leaves undisturbed the staple carrier 46 and its associated staples.Once the forward stroke and the rearward stroke of the cam housing 60are completed, the hemostat can be removed from the blood vessel 84since a staple 76 securely closes the end of said vessel. The surgeon isthen free to clamp the jaws of the hemostat on another blood vessel andrepeat the indexing, staple driving and return operations.

' makes possible the clamping of a blood vessel by means of a hemostat,the rapid sealing of said vessel by means of a staple,

and the quick removal of the hemostat in readiness for another staplingoperation.

Furthermore, the staple cartridge of the present invention isinexpensive to manufacture and is easily secured to a hemostat.Therefore, such a cartridge can be loaded with staples duringmanufacture and can be packaged in a surgically sterile container. Inthis manner, the surgeon can open the cartridge container in theoperating room, can secure said cartridge to a hemostat, can dispose ofsaid cartridge upon the exhaustion of its staples, and can quicklyintroduce to the hemostat another presterilized staple cartridge. Asnoted in the preceding paragraph, the inventive "hemostat makes itpossible for the surgeon, in the operating room, to perform a series ofstapling operations and, when the staple cartridge is exhausted, toeasily replace the exhausted cartridge with a fresh cartridge. In thisregard, two alternative replacement techniques present themselves. Thefirst technique, the more costly of the two, envisions that thecartridge complete with its bracket, be replaced upon exhaustion if itsstaples. The second technique, while more economical on a cost basis,results in some loss of time in the operating room, contemplating thatonly the exhausted cartridge be replaced, the bracket remaining mountedon the hemostat.

If the first technique is employed, the surgeon, upon exhaustion of hiscartridge, opens the jaws of the hemostat l2, and slides the bracket it)forward until the flange 22 abuts the pin 42. Then the bracket is movedagainst the bias of the spring 28 until the flange extends over the pin.Then the bracket is further slid forward until the jaws of the hemostatbecome disengaged from the cavity 40. Then, the flange 22 is easilydisengaged from the hemostat 12. A fresh cartridge, with its associatedbracket, is inserted on the hemostat 12 by first opening the hemostat,by engaging the flange 22 on the handle portion 16, by then closing thejaws of the hemostat,

and finally by sliding the bracket in a rearward direction until thecavity 40 encircles the jaws of the hemostat.

' Y which is preferably threaded into the wall 34 and removes the entirecartridge assembly 44 from the bracket 10. Then, upon opening a freshcartridge, the surgeon slides the same into the cavity 40 and, when thepivot of the staple driver 58 is in'alignment with the threaded openingin the wall 34, the pin 36 is replaced, thereby securing the cartridge44 in the housing 10.

There has been illustrated and described what is considered to be thepreferred embodiment of the invention. It will be understood, however,that various modifications may be made without departing from thebroader scope of the invention as described by the following claims.

I claim:

l. A staple attachment adapted for mounting on a clamping tool of thetype having a pair of gripping jaws and comprising:

staple-carrying means in the form of a threaded screw wherein the threadof said screw is adapted to carry a plurality of staples;

cylindrical cam means fixedly attached to said staplecarrying means;

a staple housing surrounding said staple-carrying means and serving toprovide a guide in which said staple-carrying means can rotate;

a staple driver pivotally attached to said staple housing and capable offorcing out of said staple housing a staple which is positioned forejection;

a cam housing in the form of a solid block of material having therein acylindrical bore adapted to receive said cylindrical cam, said camhousing serving to provide a guide in which said cylindrical cam cansimultaneously rotate about its axis and slide in the direction of itsaxis; cam pin means associated with said cylindrical cam means and saidcam housing for rotating said cylindrical cam means in response to theaxial sliding of said cylindrical cam means; staple ejecting meanspivotally attached to said cam housing for causing said staple driver torotate about its pivot point; and

a bracket adapted to be slideably attached to said clamping tool forsupporting said staple housing and said staple driver.

2. The invention as set forth in claim 1 wherein a portion of saidbracket forms an anvil adapted to receive staples ejected from saidstaple housing.

3. The invention as recited in claim 2 wherein said staple driver ispivotally attached to said staple housing by a pin and wherein said pinis attached to said bracket securing said driver and said housing tosaid bracket.

4. The invention as recited in claim 3 wherein said cam pin means isfixedly attached to said cam housing and extends into the bore thereofand wherein said cylindrical cam has set thereinto a series of groovespositively engaged by said cam prn.

5. The invention as recited in claim 4 wherein said cam housing and itsassociated staple-ejecting means are mounted on said bracket forstroking in a forward and rearward direction and wherein said strokingcauses said cam housing and said staple-ejecting means to move relativeto said staple housing, said staple driver and said bracket.

6. The invention as recited in claim 5 wherein said stapleejecting meansis a wedge which slides against an inside wall of said bracket and whichforces said staple driver to rotate about its axis only after saidsingle staple is in a position ready for ejection, said wedge causingrotation in said staple driver as a result of the forward stroke of saidcam housing.

' 7. The invention as recited in claim 6 wherein said bracket has twobasic positions with respect to said clamping tool, the

first being one of readiness wherein said clamping tool can functionnormally and the second being adapted for stapling wherein the clampingtool is in engagement with the object to be stapled, said first positionbeing rearward of the gripping jaws of said tool and said secondposition being one of engagement with said gripping jaws.

8. The invention as recited in claim 7 wherein said bracket has a firstflange portion for engaging one of the handles of said hemostat, asecond flange portion for engaging two walls of said hemostat near itsgripping jaws and a third flange portion, intermediate said first andsaid second flange portions, for engaging an additional two walls ofsaid hemostat.

9. The invention as set forth in claim 8 and further comprisingresilient means associated with said bracket for insuring a secure fitbetween said bracket and said clamping tool at the handle portionthereof.

10. The invention as recited in claim 5 wherein the pitch of the threadof said staple-carrying means is such that a single staple is advancedinto a position ready for ejection each time said cam housing undergoesa forward stroke.

11. The invention are recited in claim 6 wherein said staple housing isof a length substantially equal to that of said staplecarrying means.

12. The invention as recited in claim 11 wherein said staple hammer isof a length substantially equal to that of said staple housing.

13. An attachment adapted for mounting on a clamping tool I such as anhemostat which provides said clamping tool with the additionalcapability of stapling closed the end of the object being clamped, andcomprising:

stapling means for closing the end of said object being clamped by saidclamping tool, said stapling means comprising screw means for carrying aplurality of staples, means for rotating said screw means therebyadvancing said staples, and means for singly ejecting said staplingmeans and said mounting means form an integral unit. staples; and 15.The attachment as set forth in claim 14 wherein said means fordetachably mounting said stapling m n on m mounting means is such thatsaid attachment is slidably body f said clamping tooL mounted on thebody of said clamping tool.

14. The invention as recited in claim 13 wherein said

1. A staple attachment adapted for mounting on a clamping tool of thetype having a pair of gripping jaws and comprising: staple-carryingmeans in the form of a threaded screw wherein the thread of said screwis adapted to carry a plurality of staples; cylindrical cam meansfixedly attached to said staple-carrying means; a staple housingsurrounding said staple-carrying means and serving to provide a guide inwhich said staple-carrying means can rotate; a staple driver pivotallyattached to said staple housing and capable of forcing out of saidstaple housing a staple which is positioned for ejection; a cam housingin the form of a solid block of material having therein a cylindricalbore adapted to receive said cylindrical cam, said cam housing servingto provide a guide in which said cylindrical cam can simultaneouslyrotate about its axis and slide in the direction of its axis; cam pinmeans associated with said cylindrical cam means and said cam housingfor rotating said cylindrical cam means in response to the axial slidingof said cylindrical cam means; staple ejecting means pivotally attachedto said cam housing for causing said staple driver to rotate about itspivot point; and a bracket adapted to be slideably attached to saidclamping tool for supporting said staple housing and said staple driver.2. The invention as set forth in claim 1 wherein a portion of saidbracket forms an anvil adapted to receive staples ejected from saidstaple housing.
 3. The invention as recited in claim 2 wherein saidstaple driver is pivotally attached to said staple housing by a pin andwherein said pin is attached to said bracket securing said driver andsaid housing to said bracket.
 4. The invention as recited in claim 3wherein said cam pin means is fixedly attached to said cam housing andextends into the bore thereof and wherein said cylindrical cam has setthereinto a series of grooves positively engaged by said cam pin.
 5. Theinvention as recited in claim 4 wherein said cam housing and itsassociated staple-ejecting means are mounted on said bracket forstroking in a forward and rearward direction and wherein said strokingcauses said cam housing and said staple-ejecting means to move relativeto said staple housing, said staple driver and said bracket.
 6. Theinvention as recited in claim 5 wherein said staple-ejecting means is awedge which slides against an inside wall of said bracket and whichforces said staple driver to rotate about its axis only after saidsingle staple is in a position ready for ejection, said wedge causingrotation in said staple driver as a result of the forward stroke of saidcam housing.
 7. The invention as recited in claim 6 wherein said brackethas two basic positions with respect to said clamping tool, the firstbeing one of readiness wherein said clamping tool can function normallyand the second being adapted for stapling wherein the clamping tool isin engagement with the object to be stapled, said first position beingrearward of the gripping jaws of said tool and said second positionbeing one of engagement with said gripping jaws.
 8. The invention asrecited in claim 7 wherein said bracket has a first flange portion forengaging one of the handles of said hemostat, a second flange portionfor engaging two walls of said hemostat near its gripping jaws and athird flange portion, intermediate said first and said second flangeportions, for engaging an additional two walls of said hemostat.
 9. Theinvention as set forth in claim 8 and further comprising resilient meansassociated with said bracket for insuring a secure fit between saidbracket and said clamping tool at the handle portion thereof.
 10. Theinvention as recited in claim 5 wherein the pitch of the thread of saidstaple-carrying means is such that a single staple is advanced into aposition ready for ejection each time said cam housing undergoes aforward stroke.
 11. The invention are recited in claim 6 wherein saidstaple housing is of a length substantially equal to that of saidstaple-carrying means.
 12. The invention as recited in claim 11 whereinsaid staple hammer is of a length substantially equal to that of saidstaple housing.
 13. An attachment adapted for mounting on a clampingtool such as an hemostat which provides said clamping tool with theadditional capability of stapling closed the end of the object beingclamped, and comprising: stapling means for closing the end of saidobject being clamped by said clamping tool, said stapling meanscomprising screw means for carrying a plurality of staples, means forrotating said screw means thereby advancing said staples, and means forsingly ejecting said staples; and means for detachably mounting saidstapling means on the body of said clamping tool.
 14. The invention asrecited in claim 13 wherein said stapling means and said mounting meansform an integral unit.
 15. The attachment as set forth in claim 14wherein said mounting means is such that said attachment is slidablymounted on the body of said clamping tool.